Spontaneous Bone Regeneration in an Open Segmental Fracture of the Forearm with Extruded Middle Segment

Bibek, K; Vaishya, Raju; Agarwal, Amit Kumar

doi:10.7759/cureus.772

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…3 The extent of soft tissue damage, the way of debridement and irrigation, the duration between trauma and beginning of primary treatment, and sufficient antibiotic coverage are important factors involved in the infection. 3 In addition, in cases with extruded bone segments, factors including adequate sterilization of the extruded fragment, delayed reimplantation, and definitive fixation, as well as the patient's young age and excellent health play a crucial role in the decision regarding reimplantation. 1 2 3…”

Section: Discussionmentioning

confidence: 99%

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Reimplantation of a Large Extruded Segment of Tibia in an Open Fracture in a Pediatric Patient

Afshar

Tabrizi

2019

Surg J

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A 6-year-old boy presented with a Gustilo type IIIB open fracture on his left leg with a segment of bone loss in his tibia. The boy's attendants brought two bone fragments recovered from the scene of the accident. The extruded bones were a segment with a length of 5.5 cm and a cortical bone with a length of 4 cm. The extruded fragments were reimplanted after scrubbing with 10% povidone–iodine for 20 minutes, soaking in 2% chlorhexidine solution for 20 minutes, and rinsing with normal saline. Four months after the injury, the extruded fragments were incorporated in the callus of the fracture site and complete fracture union in appropriate alignment was achieved.

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Section: Discussionmentioning

confidence: 99%

“…3 In addition, in cases with extruded bone segments, factors including adequate sterilization of the extruded fragment, delayed reimplantation, and definitive fixation, as well as the patient's young age and excellent health play a crucial role in the decision regarding reimplantation. 1 2 3…”

Section: Discussionmentioning

confidence: 99%

Reimplantation of a Large Extruded Segment of Tibia in an Open Fracture in a Pediatric Patient

Afshar

Tabrizi

2019

Surg J

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“…However, there are also deficiencies. For example, autologous bone transplantation can cause injuries on the bone removal site [ 4 ], whereas transplantation of allogeneic bone may lead to rejection [ 5 ]. Therefore, the development of filling materials with bone induction and bone conduction ability would be key to treating open fractures complicated by bone defects.…”

Section: Introductionmentioning

confidence: 99%

Cefazolin/BMP-2-Loaded Mesoporous Silica Nanoparticles for the Repair of Open Fractures with Bone Defects

Shen

Wang

et al. 2022

Oxidative Medicine and Cellular Longevity

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The study aimed to explore the feasibility of a nanodrug delivery system to treat open fractures with bone defects. We developed a cefazolin (Cef)/bone morphogenetic protein 2 (BMP-2)@mesoporous silica nanoparticle (MSN) delivery system; meanwhile, Cef/MBP-2@ poly(lactic-co-glycolic acid) (PLGA) was also developed as control. For the purpose of determining the osteogenic and anti-inflammatory actions of the nanodelivery system, we cultured bone marrow mesenchymal stem cells (BMSCs) and constructed a bone defect mouse model to evaluate its clinical efficacy. After physicochemical property testing, we determined that MSN had good stability and did not easily accumulate or precipitate and it could effectively prolong the Cef’s half-life by nearly eight times. In BMSCs, we found that compared with the PLGA delivery system, MSNs better penetrated into the bone tissue, thus effectively increasing BMSCs’ proliferation and migration ability to facilitate bone defect repair. Furthermore, the MSN delivery system could improve BMSCs’ mineralization indexes (alkaline phosphatase [ALP], osteocalcin [OCN], and collagen I [Col I]) to effectively improve its osteogenic ability. Moreover, the MSN delivery system could inhibit inflammation in bone defect mice, which was mainly reflected in its ability to reduce the release of IL-1β and IL-4 and increase IL-10 levels; it could also effectively reduce apoptosis of CD4+ and CD8+ T cells, thus improving their immune function. Furthermore, the percentage of new bones, bone mineral density, trabecular volume, and trabecular numbers in the fracture region were improved in mice treated with MSN, which allowed better repair of bone defects. Hence, Cef/BMP-2@MSN may be feasible for open fractures with bone defects.

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Cambridge experience in spontaneous bone regeneration after traumatic segmental bone defect: a case series and review of literature

Abdulkarim

Walker

et al. 2020

BMJ Case Rep

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High-energy traumatic long bone defects are some of the most challenging to reconstruct. Although cases of spontaneous bone regeneration in these defects have been reported, we are aware of no management guidelines or recommendations for when spontaneous bone regeneration should be considered a viable management option. We aim to identify how certain patient characteristics and surgical factors may help predict spontaneous bone regeneration. A total of 26 cases with traumatic segmental defects were treated at our institution, with eight cases (30.8%) undergoing spontaneous regeneration. We discuss four in detail. Six (75%) reported a degree of periosteal preservation, four (50%) were associated with traumatic brain injury and none were complicated by infection. The average time to spontaneous bone regeneration was 2.06 months. According to our cases, patients with favourable characteristics may benefit from delaying surgical treatment by 6 weeks to monitor for any signs of spontaneous bone formation.

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Spontaneous Bone Regeneration in an Open Segmental Fracture of the Forearm with Extruded Middle Segment

Cited by 4 publications

References 10 publications

Reimplantation of a Large Extruded Segment of Tibia in an Open Fracture in a Pediatric Patient

Reimplantation of a Large Extruded Segment of Tibia in an Open Fracture in a Pediatric Patient

Cefazolin/BMP-2-Loaded Mesoporous Silica Nanoparticles for the Repair of Open Fractures with Bone Defects

Cambridge experience in spontaneous bone regeneration after traumatic segmental bone defect: a case series and review of literature

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